NPI | 1972651222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MA 24083) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03228394) |
Enumeration Date | 2007-01-05 |
Last Update Date | 2018-04-09 |